Stable Angina

Question 1

How do we class angina as stable

Answer 1

Symptoms always relieve by rest of GTN

Question 2

Gold standard investigation of stable angina

Answer 2

CT Coronary Angiography to show stenosis

Question 3

What drug requires U&Es prior

Answer 3

ACEi

Question 4

What drug requires LFTs prior

Answer 4

statins

Question 5

Stable angina medical management- immediate symptomatic relief

Answer 5

GTN spray
Repeat after 5 mins
If pain remains–> 999

Question 6

Stable angina long term symptomatic relief

Answer 6

Beta blocker (bisoprolol 5mg OD)
Ca channel blocker (amlodipine 5mg OD)

2nd line
Long acting nitrates (Eg isosorbide mononitrate)
Ivabradine
Nicorandil
Ranolazine

Question 7

Secondary prevention stable angina

Answer 7

Aspirin 75mg OD
Atorvastatin 80mg OD
ACEi

Question 8

Surgical interventions for stable angina

Answer 8

1) PCI with coronary angioplasty
Dilates blood vessel w a balloon and/or inserting stent
Insert a catheter through femoral artery

2) CABG

Question 9

If Ca channel blocker used as monotherapy in stable angina, which do we use?

Answer 9

Verapamil or diltiazem

Rate-limiting

Question 10

If Ca channel blocker used in combo with BB in stable angina, which do we use?

Answer 10

Nifedipine

A long-acting dihydropyridine calcium-channel blocker

Question 11

What do we avoid using in combination with verapamil and why?

Answer 11

BB

risk of complete heart block